From the Doctor’s Desk…

At a recent continuing education class I was asked by a fellow doctor about treating depression with nutritional supplements alongside or in place of prescription drugs, in the context of medications sometimes having severe side effects that further complicate cases. This doctor used our Mood Support™ formula as a specific example, asking if a patient could safely take it while weaning off of Zoloft. This article may help to inform and clarify the question of using prescribed antidepressants along with supplements, possibly even replacing prescription drugs with natural supplements.

Antidepressants are the most prescribed therapy for depression. The exact mechanism of action of antidepressants, more simply put, how they work, is listed as ‘unknown.’ The prevailing theory is that antidepressants increase the concentration of brain chemicals, or neurotransmitters, used by the brain’s nerves to communicate with one another. The neurotransmitters affected by antidepressants are norepinephrine, serotonin and dopamine. The different classes of antidepressants differ in the neurotransmitters they affect.

Monoamine oxidase inhibitors (MAOIs) were the first class of antidepressants to be developed (Nardil, Parnate and Marplan). MAOIs elevate the levels of norepinephrine, serotonin and dopamine by inhibiting the enzyme monoamine oxidase.

Tricyclic antidepressants (TCAs) have been in use since the 1950s when Imipramine (Tofranil) was shown to be effective in treating depression. TCAs primarily work by increasing the level of norepinephrine and to a lesser extent serotonin levels in the brain. Elavil, Anafranil and Norpramin are other examples of TCAs.

Selective serotonin reuptake inhibitors (SSRIs) are the latest antidepressants that include Prozac, Paxil and Zoloft and were developed after TCAs. These are the most widely used class of antidepressants. They work by increasing the level of serotonin in the brain. Unlike MAOIs and TCAs, they do not significantly affect norepinephrine levels in the brain.

The raw materials in our Mood Support™ formula that increase serotonin in the brain are 5-hydroxytryptophan (5-HTP) and St. John’s wort. Taking 5-HTP or St. John’s wort (due to the hypericin content) is contraindicated by the prescription antidepressants that also work by elevating brain serotonin. MPN Mood Support™ formula promotes positive mood, emotional calmness and well-being. The B complex vitamins in our formula influence positive mood regulation, support normal neurological function and stabilize brain levels of serotonin.

Patients should not be taking antidepressant drugs along with any nutritional supplement that contains formula 5-HTP or St. John’s wort. There really is no easy transition from prescriptions to nutritional supplements once prescription drugs are in the patient’s system. If possible, begin treatment for mild depression with a nutritional supplement such as MPN’s Mood Support™ formula as well as therapy that addresses the patient’s issues surrounding their depression.

If the patient is already using prescription meds, ‘easy does it’ and gradual withdrawal from medication is recommended. A maximum tapering off of the prescribed dosage of 5% per week works best. When the patient is down to the smallest dose, it’s possible to consider prescribing a liquid /oral suspension 10mg/5ml of the SSRI they are taking. It will take 20 weeks and sometimes longer to get off antidepressants. It is much easier to start a treatment plan that does not create a 20-week withdrawal period. Feel free to call with any questions you may have about our Mood Support™ formula.